To explore the value of preperitoneal space anatomy in laparoscopic total extraperitoneal hernia repair (TEP).

From April 2015 to January 2017, a total of 158 patients undergoing TEP surgery were performed at the Sanming Second Hospital. The intraoperative observation, surgical video analysis, and postoperative follow-up were performed.

TEP were successfully completed in all cases. The study found that there were two layers of the transversalis fascia, and the posterior fascia divided the preperitoneal space into two space. The first space between the anterior and posterior layers of the transversalis fascia, the second between the peritoneum and the posterior layer of the transversalis fascia. In this group, 68 cases (43%) were separated via the first space, 90 cases (57%) were separated via the second space. Peritoneal anterior ring were present in 75 cases (47%). Peritoneum broken in 35 cases (22%). The operation time was (40±10) minutes, the hospitalization time was 24 to 48 hours. There were 10 cases (6%) of seromas. The patients were followed up for 6 to 24 months. No cases of chronic pain were found.

Understanding the anatomy of the preperitoneal space is helpful to improve the safety of laparoscopic total extraperitoneal hernia repair, shorten the operation time, reduce the incidence of surgical complications, thereby improving the efficiency of surgery and surgical quality.